Plantar Fasciitis Treatment Experiences? (Read 51 times)

1 - What is the root cause for the PF though? Has anybody diagnosed that ? What causes the issue that causes the pain ?

2 - Is it the fascia itself that is ruptured or otherwise inflammed, or is it a nerve that pinches the fascia ? Or both ? Is it possible that you have some sort of hip alignment issue / or weak gluteus medius , or something else up the chain that causes extra strain on the fascia ?

3 - What kind of strengthening have you done ? Was it something like Barbell Squats and deadlifts to strengthen the core in general (abs, lower back, gluteus, hip flexors etc ? Or was it something specific to the foot or ankle ?

4 - What kind of shoes do you wear ? Are they very low to the ground ? or more like Hokas ?

5 - Do you wear inserts ?

6 - Was the physiotherapy one of those that do warm or cold patches, or micro shocks ? Or was it the kind that does manipulation massage to diagnose the root cause and release some of the tighter muscles / nerves ?

In my case, the root cause was usually the calves that were too tight, or it was a nerve that runs on the side of the calf under the fascia. In both cases physical therapy via manipulation massage plus foam rolling the calves, glutes and hip flexor before every run helped.

I know I had a lighter case though.

Thanks for the replies and sorry for my delay in response - allergies knocked me out last week. I am doing Deep Tissue Laser Therapy now. If that doesn't help, I may elect to move to Gastroc/Strayer surgery. Fingers crossed that this helps! I've had three treatments though, and so far, not much of any relief. 

Here are my answers to the questions asked:

1 - What is the root cause for the PF though? Has anybody diagnosed that ? What causes the issue that causes the pain ?

• Tight calves, flat feet (had since I was a kid), and nearly no mobility in ankle - likely a little bit of overuse compounded with movement issue.

2 - Is it the fascia itself that is ruptured or otherwise inflammed, or is it a nerve that pinches the fascia ? Or both ? Is it possible that you have some sort of hip alignment issue / or weak gluteus medius , or something else up the chain that causes extra strain on the fascia ?

• Fascia inflamed - acute PF on chronic PF. No nerve pinching seen on MRI.
• And yes, definitely working on balance/strengthening exercises from PT for the hip on down

3 - What kind of strengthening have you done ? Was it something like Barbell Squats and deadlifts to strengthen the core in general (abs, lower back, gluteus, hip flexors etc ? Or was it something specific to the foot or ankle ?

• Foot arching, marble pickups, ankle side-to-side/ankle front-to-back, one foot balance stand, one foot balance stand with other foot extending out to side and back (2x 10x sets), stretching on slant board, squat/side steps with resistance band, etc....

4 - What kind of shoes do you wear ? Are they very low to the ground ? or more like Hokas ?

• Asics Kayano-30s or Oofos Recovery Sandals - both podiatrist approved  

5 - Do you wear inserts ? NO. Podiatrist did not feel they were necessary/helpful in my case. I tried inserts (RX and OTC) in the past during other flare ups of PF and found they didn't help, either.

6 - Was the physiotherapy one of those that do warm or cold patches, or micro shocks ? Or was it the kind that does manipulation massage to diagnose the root cause and release some of the tighter muscles / nerves ?

• PT was exercises and then Graston work on foot and calves. We did a little kinesio taping, but I have sensitive skin and it does not like most any adhesives. 

1 - Have you checked if your talus bone has moved forward ? That's also something that happens sometimes and when it does that it blocks the path for proper ankle dorsiflexion.

• They haven't mentioned that as an issue and I've had MRIs done.

2 - Have you tried heavier lifting like barbell squats and deadlifts ? The reason I ask is because over time that has helped me a lot in off loading the lower leg and having the core (hips, glutes, abs, hamstrings) take more of the brunt of the work to stabilize and cushion each step.

So now the lower leg (calves/achilles/fascia) have a bit less work to do.

• Good call out! I have not done that in a while - I used to lift though. I would like to get back to lifting, but I am so inflamed that putting any weight on it is difficult at this point - and it sometimes hurt with no weight on it.

3 - Does foam rolling your calves help with alleviating some of the tightness ?

• It does somewhat, as does the percussive therapy gun and/or self-massage.

Good question, but I'm just following the podiatrist's recommendation. She said of the two surgical options, the Gastroc/Strayer would probably have more success for me. I do not know my score on the wall test.

Also, if you were to go down the surgery route, wouldn't it make more sense to have a surgery to correct your ankle mobility instead?

Cause that stiff static ankle is probably what causes the super tight gastroc and soleus which in turn irritates the plantar fascia.

Maybe there's a tendon malfunctioning in your ankle, maybe the bone grew too much, but either way, it seems that fixing the ankle mobility would be key to improve everything else.

 

How do you score in this knee to wall test ?

https://www.youtube.com/watch?v=U7woPNLUT3Q

 

I score 12cm on the right side and 9cm on the left side. The minimum dorsiflexion to run is said to be at 5 inches, 12.5cm, so you can see I fail both.

I went to a private podiatry clinic, in my case it was with https://www.akilespodologiaisalut.com/. I'm still undergoing ultrasound sessions and injections, and feeling much better. Hang in there, you'll improve